PDD. The story of Chanel

The Chanel's case shows that commitment and perseverance bring results!

In February, 2020, Chanel was presented for a second opinion because her long illness looked at a desperate stage.  

This young Blue and Gold Macaw had been sick for over one year and no therapies - antibiotics, antifungals, steroids, vitamines by different ways - had any effect.

When I met her for the first time, Chanel was very thin (820 gr), unable to stand on her feet for weakness and, most worrying thing, severely dyspnoic.

Chanel (1)

Chanel (2)

Immediately we put the bird in an heated cage with a supplement of oxygen, with only a minimal relief: then we gave her some fluids and a mild sedative, hoping that she would breath better if less anxious and scared.

Bloodworks showed a generic liver and gastrointestinal illness, and a mild rise of white blood cells, suggesting an active immune response. A tracheal swab shows only a bacterial infection and rule outs any fungal problem (which was one of ours main differentials!)

Chanel, being persistently dyspnoic, was hospitalized for intensive therapy. After some hours we took the risk of a quick sedation for x-ray and also put a tube in the caudal air sac. This last technique is very useful when a bird is dyspnoic because some obstruction keep air from flowing to lungs, but didn't help Chanel at all. We then understood that her lung tissue was not working properly.

A complet therapy with fluids, vitamines, meloxicam, antibiotic (selected from the C&S test) and nebulization with F10 was carried on, but the bird showed only a minimal improvement. Chanel was still ataxic, unable to stand and subject to frequent fit of trembling. She was barely nibbling something and undigested food was evident in her stool.

48h later we took another x-ray after gavaging 5 ml of iodine contrast media in 40 ml of handfeeding formula and confirmed our suspect: Chanel's peristalsis was very slow and her proventricolous markedly dilated.

Rx with contrast media

These results allowed us to give a suspect diagnosis of Avian Ganglioneurits (AGN or PDD) complicated by a pneumonia, probably from inhalation of food or fluids caused by abnormal peristalsis. This suspect would need some exams to be confirmed:

- PCR Bornavirus

- sierology for antigangliosides antibodies

- crop biopsy

Chanel condition was judged not stable enough to allow further exams, so she was released with a complex therapy oriented to mitigate her respiratory and neurologic symptoms.

The restrictions needed because of Covid-19 pandemia prevented the owner (living in another city) from presenting Chanel for follow-up: by phone we were informed that the macaw was still alive and, very slowly, improving!

In May at last the owner is allowed to travel and bring Chanel for a follow-up. Now Chanel weights 850 gr, is able to stand and to walk, she won't fly but has begun to perch for sleeping.

The owner didn't return her to the external flight, but in the cage she is much more independent, eats mostly by herself and her life quality has improved.

Unfortunately she is not stable for prolonged anaesthesia yet, so we didn't proceed to crop biopsy: we managed to repeat the x-ray (confirming the proventricular dilatation) and a blood sample, for general profile and the much needed finding of antigangliosides antibodies, linked to the peripheral nerves inflamation, main alteration of AGN/PDD. Chanel is positive for these antibodies and this, with her clinical signs, allow us to confirm the diagnosis of PDD.

Without losing heart, we improved the therapeutic plan for Chanel, choosing oral medications useful to normalize her pathological inflamatory response and improve her neurological signs.

Three months later, the owner updated us: Chanel is back to her external flight, where she moves normally, walking, climbing, hopping from perch to perch. She breaths well, can feed unassisted on pellets, cooked cereals and legumes, fruit plus dry seeds once a week, with no undigested food in droppings. With just the little help of some handfeeding formula every night, also as carrier for therapy, she maintain a normal weight around 900 gr and is in every way a normal macaw.

Chanel eating...